mental health treatment systems jolene rebertus, ma, lpcc, ncc corrections program director...

Mental Health Treatment Systems

Jolene Rebertus, MA, LPCC, NCC Corrections Program DirectorBehavioral Health Release Planning

‖ Jolene Rebertus, MA, LPCC, NCC

‖ Corrections Program Director – Behavioral Health Release Planning

‖ Kathryn Lockie, MA, LPCC

‖ Corrections Program Director – MCF-Oak Park Heights

Treatment SystemsOverview

1. Review DOC treatment systems 2. Discuss offered release planning services

DOC Treatment Systems

Behavioral Health Mission "To provide effective, evidence-based behavioral health

services that enhance facility and public safety, reduce criminal recidivism, and foster healthier offender functioning."

DOC Background: MH Services


Behavioral health includes Mental health Chemical dependency Sex offender Release planning

200+ staff All State employees



Mental Health Services by the numbers Approx 25% adult males utilize ongoing mental health

services Approx 22% adult males on psychotropic medications Approx 65% adult females utilize ongoing mental health

services Approx 68% adult females receiving psychotropic

medication



Continuum of Services Available through self, professional, or institutional referral

ANY DEPARTMENT STAFF MAY REQUEST A MENTAL HEALTH ASSESSMENT OF AN OFFENDER

Evaluations are provided at various levels of referral and need

DOC Background: MH Services & DOC Division Directive 500.303


Offender Intake Screening and Processing New admit - mental health screen completed within 14

calendar days of admission Release violator – mental health screen completed within

14 calendar days of admission Transfer – behavioral health staff sending facility prepares

summary and need for follow up to receiving facility

MN DOC Division Directive: 202.040


Mental Health Assessment Suicidal ideation History of suicidal behavior Prescribed psychiatric medication Current mental health complaint Out/inpatient history Substance use Observation of appearance Evidence of abuse or trauma Current symptoms Disposition

MN DOC Division Directive: 500.303


Those with a history, suicidal ideation, and/or display symptoms participate in further evaluation

File review Additional clinical interviews Obtaining collateral material from outside resources Psychological testing



Mental Health Continuity of Care Ensure offenders receiving mental health care in the

community are provided appropriate care during admission, incarceration, transfer, and release

MN Department of Corrections Policy: 500.302


Level 1 Volunteer assistance Referral to self-help groups

– AA– NA– Anger management– Parenting


Level 2 Provided by DOC

professional staff Outpatient

intervention Psychoeducational

groups Psychotherapy

groups Individual

psychotherapy

INTERVENTION SERVICES


Level 3 DOC professional staff Heightened level of supportive services

Chronically mentally ill Socially low functioning

Supportive Living Services (SLS) Residential level services

– Daily support– Designated area


Level 4 Acute level of mental

illness Requires residential

care Specialty assessment Chronic mental health

care within a secure environment

INTERVENTION SERVICES


Additional Services Psychiatric Services

All psychiatric providers are contract providers Psychiatric medication management Medical practitioners must provide non-neuroleptic,

psychotropic medications only when medically indicated for treatment of mental illness

MN Department of Corrections Policy: 500.301 & 500.321


Additional Services Mental Health Services On-Call

1 or more licensed mental health providers are continuously on-call to provide urgent mental health services

Handle situations by telephone Schedule distributed

– Watch commander– Master control– Associate warden of operations– Health services administrator– All mental health providers



Additional Services Mental Health Observation - COS

Comprehensive mental health and suicide prevention program

– Offender placed on restrictive conditions– Physical and electronic observation– Logging behavior– Directly observed medication administration– Behavioral health staff must meet with offender

daily– Termination determined by behavioral health staff



Psychiatry and outpatient services provided at each DOC facility

What is unique to each facility?


MCF- Oak Park Heights Mental Health Unit

Process-type groups– Time to talk about person issues/struggles,

thoughts, feelings Psychoeducation-type groups

– Educational components» Symptom management» Adjustment to prison» MH cycle & interventions


MCF- OPH Mental Health Unit

CD Pre-treatment groups– Does not fulfill mandatory CD requirements– Help prepare for future treatment– Resource for seeking CD information

Pre-release groups– For offenders within 1 year of release

» Housing, employment, supervision, medical/mental health aftercare


MCF-OPH Outpatient services

Offered groups– “Doing Time”– Poetry– Outpatient MHU group– Anger management


MCF- Stillwater Transitions Services Program (TSP)

Serious and persistent mental illness Roughly 10 inmates 2 inmate mentors Attend group counseling sessions 2x week

– General mental health education, symptom management, process group

Expectation of actively working towards general population, seeking employment, working knowledge of dealing with mental illness


MCF-Rush City Supportive Living Services (SLS)

32 beds 2-3 groups a week

– Anger management– Community/Social skills– Depression management– Grief process– Special topics– STEPPS– Personal goals


MCF- Lino Lakes Supportive Living Services (SLS)

Serious mental illness and/or significant cognitive impairment

Groups offered– Adaptive living skills group– Psychological education– Daily living skills– Mental health movie activity– Art and gardening– Recovery group


MCF-LL Outpatient services

Coping Skills group– Offered 1x week– Relaxation skills– Problem solving– Goal planning– Sleep hygiene

Work readiness– Provide variety of tasks while under staff supervision– Allow to practice skills, working with others and self

discipline


MCF- Shakopee Women of Wellness (WOW)

Supportive living unit Provides psycho-education, skills and therapy to

offenders in order to better manage mental health symptoms

Goal to return to general population 21 days


MCF-SHK Women of Wellness – Pain Management (WOW-PM) Women of Wellness – Transition (WOW-T)

21 days Begin working

Women of Wellness – Extended (WOW-E) Women of Wellness – General Population Aftercare

(WOW-GPAC)

Release Planning in Behavioral Health

http://www.youtube.com/watch?v=AcBg1qfNoeM&feature=related Approach

Prevention through planning and actionMN DOC Release Planners

SPMI SO CD Medical TBI

http://www.youtube.com/watch?v=AcBg1qfNoeM&feature=related

http://www.youtube.com/watch?v=AcBg1qfNoeM&feature=related

Community “Philosophy”

Wisconsin Minnesota

State population 5.6M 5.0M

Probation population 53K 130K

Prison population 23-24K 9.5K

% incarcerated 43% 7%

www.nicic.org/Features/StateStats

Mental Health Release Planning

• Function as a mental health practitioner• Assess and review client management

needs• Create individualized discharge plan

aimed at successful integration into the community


Introduction Significant increase in awareness of number of mentally ill

offenders in prison population Results in homelessness, unemployment, hospitalizations,

subjection to abuse and exploitation, alcohol and drug dependence


Introduction 2002, MN State Legislature passed law requiring mental

health release planning for all SPMI offenders Community mental health services preplanned prior to

release


Importance Enhance community safety Reduce recidivism Meet state legislatively mandated laws Provide advanced notification to community social service

agencies


Importance To ensure offender access to state, county, and federal

health care Transition mental health services from prison to

community Medically based treatment that supports court’s objectives

and conditions for release Best possible aftercare for SPMI offenders


Definition of Serious and Persistent Mental Illness (SPMI) A person has diagnosis of:

Schizophrenia Bipolar Disorder Major Depressive Disorder Borderline Personality Disorder Schizoaffective Disorder


How to identify? Past records

Pre-sentence investigations Clinical records Case notes Police reports

Offender interview Have you ever been hospitalized? Have you seen a counselor or therapist? Do you have a mental health diagnosis? Medications?


• Begin working with offender 120 days prior to release• Voluntary Service• Limits of Confidentiality• Assessment of need completed• Obtain emergency contact, recreational activities, etc.


County Mental Health Case Management Rule 79 Assessment

Each county has their own rule 79 assessment Certifies a person with a serious and persistent mental illness

County involvement important in order to assist with connecting offender to community mental health resources Day tx. MI/CD groups Vocational programming Housing Funds


ARMHS-Adult Rehabilitative Mental Health Services Medical Assistance required Intensive Community services that focus on offender’s

mental health stability in community


MN Department of Economic Assistance GAMC (expired 02/28/11) MN Care MA Expansion (March 2011) MNSure SMRT Food Stamps Personal Needs Money


Financial Benefits-Social Security Multi-stage process

Referral phone call to SSA representative at 120 days SSI phone interview with offender in prison Completion of important paperwork Possible psychiatric evaluation SSI provide a means of support to pay for housing, food,

and increase the offender’s health insurance coverage


Housing Placement SPMI release planner involved in order to find appropriate

housing Rule 25 assessment for MI/CD programming Collaboration with various providers

Community agencies– Case manager– Housing manager– Economic Assistance

DOC case manager Field agent


Community appointments Outpatient Psychiatry-medication monitoring

Release medication– 30 day supply– Written script #30

Outpatient Psychology-primary therapist Community Treatment Program

Sex offender MI/CD DBT Day treatment


Employment Resources Vocational Rehabilitation Services – MN Field Offices AMICUS TASKS Unlimited Goodwill – Easter Seals New Leaf Workshop


Community Support Crisis phone numbers and outreach Local hospitals AA/NA meeting directories Transit information The essentials

Clothing, food shelves, shelters


Prevention Plan Reviewed and processed with the offender

To improve his/her cognitive thinking skills Build self-confidence in managing their mental health in

the community


Summary and Key Points Frequent communication with various parties

Within Department of Corrections Community mental health agencies Field agents

Always aware of security of facility Limits of confidentiality


‖ Look back‖ DOC Treatment Systems‖ Mental Health Release Planning


‖ QUESTIONS

mental health treatment systems jolene rebertus, ma, lpcc, ncc corrections program director...

Documents

doc treatment systems

behavioral health services

review doc treatment

mental health care

mh services slide

treatment systems overview

mh services level

release planning services